In the realm of mental health treatment, understanding the roles of different professionals can be crucial for individuals seeking the proper support. At Madison Avenue TMS & Psychiatry, people often ask, “Do psychiatrists do therapy?”
Although “therapy” can be used to refer to a range of treatments, including medical interventions, most individuals who ask this question want to know if a psychiatrist will provide “talk therapy,” also known as psychotherapy, a primarily conversation-based method of mental health treatment. With that in mind, what kind of therapy can you expect from a psychiatrist?
Do Psychiatrists Do Talk Therapy?
Yes, psychiatrists do provide talk therapy, but it’s important to distinguish their role from that of other mental health professionals. Psychiatrists are medical doctors who specialize in the diagnosis, treatment, and prevention of mental illnesses. While they are trained in various forms of therapy, such as psychotherapy or counseling, their primary focus is often on prescribing medication and managing the biological aspects of mental health conditions.
Psychiatrists also do therapy sessions with their patients, especially when medication management is part of the treatment plan. These sessions typically involve discussing medication’s effects, monitoring progress, and addressing any concerns or side effects. However, for more in-depth, regular talk therapy, individuals often seek the expertise of psychologists, counselors, or therapists who specialize in various therapeutic approaches.
The Roles Of Different Mental Health Professionals
The mental health field is diverse, with a range of professionals available to meet the needs of the public.
Psychologists are trained professionals who study and treat mental processes and behaviors, utilizing various therapeutic approaches. A distinct profession from psychiatrists, they are not medical doctors and cannot prescribe medication.
Psychiatric physician associates are healthcare professionals trained to work alongside psychiatrists, assisting in patient care and treatment planning. Their role is supplemental, so they will not usually lead a therapy session or prescribe medication.
Therapists can refer to a range of mental health professionals who employ various therapeutic techniques to assist clients in understanding and overcoming psychological difficulties. They are not medical doctors and cannot diagnose conditions or prescribe medications.
Counselors are non-medical professionals trained to guide and support individuals or groups, helping them navigate emotional and mental health challenges.
Social workers are non-medical professionals who help individuals and communities cope with various life challenges by providing support, resources, and advocacy for mental and emotional well-being. LCSW (licensed clinical social workers) can provide therapy.
Choosing the right mental health service for you can depend on various factors, including the severity of your symptoms, availability of services in your area, past treatment history, and insurance coverage.
What Treatments Can You Get From A Psychiatrist?
Talk therapy can be a powerful tool, but it often isn’t enough to address the biological basis of many mental health disorders like depression, which stem from chemical irregularities in areas of the brain, such as the prefrontal cortex. Often, some form of medical intervention is required, whether as a standalone treatment or supported by psychotherapy, and that’s where psychiatrists come in (1,2).
While pharmaceuticals such as antidepressant medications are usually the first-line treatment options, at Madison Avenue TMS & Psychiatry, we recognize the evolving landscape of mental health care and offer innovative treatments like Transcranial Magnetic Stimulation (TMS). TMS is a non-invasive and FDA-approved therapy for individuals with treatment-resistant depression or obsessive-compulsive disorder (OCD). It uses tiny magnetic pulses to stimulate specific brain areas associated with the symptoms of mood disorders to regulate neurotransmitter activity to a healthy level.
TMS is an effective alternative for individuals with depression, obsessive-compulsive disorder (OCD), anxiety, or post-traumatic stress disorder (PTSD) who may not respond well to traditional forms of psychotherapy or medication alone (3, 4, 5, 6). Unlike pharmaceutical interventions, TMS has minimal side effects and does not involve systemic exposure to drugs. At Madison Avenue TMS & Psychiatry, we work closely with patients to determine if TMS is a suitable option, providing personalized care to address the unique needs of each individual.
Do I Need A Psychiatrist?
Psychiatrists play a crucial role in addressing the biological aspects of mental illnesses, including medication management. While they do engage in therapy sessions, their primary focus is often on the medical aspects of treatment. For those seeking comprehensive mental health care, it’s essential to consider a personalized approach with the assistance of a medical doctor, such as a psychiatrist, to find the best treatment.
If you or a loved one is navigating the complexities of mental health treatment, Madison Avenue TMS & Psychiatry is here to help. Our experienced team of psychiatrists, psychiatric nurse practitioners, and psychiatric physician associates offers various services, including talk therapy, medication management, and innovative treatments like TMS.
Take the first step toward mental well-being by contacting us online or calling (212) 731-2033 for an appointment or consultation. Let us be your partner on the journey to improved mental health!
Resources:
van Bronswijk S, Moopen N, Beijers L, Ruhe HG, Peeters F. Effectiveness of psychotherapy for treatment-resistant depression: a meta-analysis and meta-regression. Psychological Medicine. 2019;49(3):366-379. Link. Accessed January 11, 2024.
Jobst A, Brakemeier E-L, Buchheim A, et al. European Psychiatric Association Guidance on psychotherapy in chronic depression across Europe. European Psychiatry. 2016;33(1):18-36. Link. Accessed January 11, 2024.
Sackeim HA, et al. Clinical Outcomes in a Large Registry of Patients with Major Depressive Disorder Treated with Transcranial Magnetic Stimulation. J Affective Disorders. 2020; 277(12):65-74. Link. Accessed January 11, 2024.
Roth Y, Barnea-Ygael N, Carmi L, Storch EA, Tendler A, and Zangen A. Deep transcranial magnetic stimulation for obsessive-compulsive disorder is efficacious even in patients who failed multiple medications and CBT. Psychiatry Research. 2020;290:113179. Link. Accessed January 11, 2024.
White D, Tavakoli S. Repetitive transcranial magnetic stimulation for treatment of major depressive disorder with comorbid generalized anxiety disorder. Ann Clin Psychiatry. 2015 Aug;27(3):192-6. Link. Accessed January 11, 2024.
Petrosino, N. J., Cosmo, C., Berlow, Y. A., Zandvakili, A., & Philip, N. S. Transcranial magnetic stimulation for post-traumatic stress disorder. Therapeutic Advances in Psychopharmacology, 2021;11. Link. Accessed January 11, 2024.
As its name suggests, bipolar disorder presents itself as a pairing of opposites: People who suffer from the mental health condition experience major depressive episodes offset by periods of manic or hypomanic behavior.
These manic or hypomanic episodes are marked by persistently elevated, expansive or irritable moods that disrupt one’s ability to function and are noticeable by others. They typically last for several days or even weeks — yet they may go years without resurfacing.
“Bipolar disorder is a very serious illness that is tricky to diagnose,” says Dr. David Woo, owner and head clinical psychiatrist at Madison Avenue TMS and Psychiatry in New York. “Most people with bipolar are initially misdiagnosed with major depression because people don’t recognize or don’t ask them about mania or hypomania. All it takes is one episode to make you bipolar.”
Bipolar I, defined by manic episodes that last at least seven days, usually accompanied by depressive episodes
Bipolar II, defined by less severe hypomanic episodes
Cyclothymic disorder, or cyclothymia, defined by a recurring cycle of hypomanic and depressive symptoms that are less intense or long-lasting, so they do not meet the clinical threshold for manic or depressive episodes
In a Q&A session, Dr. Woo spoke about how the condition presents, how it’s treated and why the manic half of the condition is especially difficult to address.
Q: You say that bipolar is both overdiagnosed and underdiagnosed. Can you explain?
A: It’s underdiagnosed in the regular practice of treating people with depression, resulting in people being put on antidepressants who shouldn’t be. It’s overdiagnosed in certain patients who have had substance-use problems, because when people are using alcohol or cocaine, there are changes in mood that can resemble bipolar disorder. So a lot of people — young people especially, who may do a lot of partying or using drugs and have mood changes — may be diagnosed quickly as bipolar if the clinician doesn’t flesh out all their substance-use issues, or if the patient doesn’t reveal them.
Also, patients who have a personality disorder are often misdiagnosed as bipolar disorder — especially something like borderline personality, where there are elements of mood elevation. They have very intense emotions that can resemble bipolar disorder.
Can you give an example or two of how a manic episode might present?
A manic episode might look like someone who one day becomes very religious. Their friends notice that the patient is talking more rapidly, and they’re staying up late. They’re sleeping less. They’re getting a lot done, but it’s kind of out of control, and they start changing their views about themselves. The patient is telling people that he is there to send a message from God. And pretty soon everyone notices that this patient is not getting his work done, not taking care of himself, looking ragged and calling people up at all hours of the night. That’s the typical bipolar I picture.
Bipolar II is similar. There’s a distinct time period when the patient has elevated energy, irritability and mood. There’s rapid thinking, rapid speech, less need for sleep and more productivity. But they’re still functional. Usually their hypomania is in the service of projects that make sense to the outside world, but it’s unusual for them.
These things are nuanced. You have to know the patient, usually more than just over the course of one hour. You have to talk to them over time to discern a pattern.
What are some of the standard treatments for bipolar, and what’s new and promising along those lines?
The standard treatment is the combination of mood stabilizers for the manic or hypomanic symptoms and antipsychotics for the depressive episodes.
Supportive cognitive behavioral psychotherapy can play a big role in helping bipolar patients be aware of their symptoms, learn how to recognize them and know how to get help when they need it. It can help them adopt good practices in their life like getting enough sleep and avoiding triggers like substances, conflicts with people or being under a lot of stress.
In general, it’s thought that people with bipolar disorder need to be on medications, whereas that may not be true for people with major depressive disorders. They often respond well to psychotherapy, exercise, changes in their circumstances, things like that.
It’s not FDA-approved for bipolar, so nobody will cover it. I’ve had people who are bipolar pay out of pocket for TMS.
I recommend it only if someone’s on a mood stabilizer. That way, I feel confident that they won’t be triggered into a manic episode, because anything that treats depression has the potential to trigger hypomania or mania.
Likewise, I wouldn’t feel comfortable giving an antidepressant to a bipolar patient without having something else on board to catch them if they become manic or hypomanic.
What are the success rates that you see in terms of treating bipolar? And what does success mean?
Success is either having a response or remission.
With the depression side, if someone has never been on medication, there’s a two-thirds chance you’ll have at least some sort of response, and half of that 67% will go into remission.
It’s the manic or hypomanic aspects that complicate things. When it comes to treatment, it’s not about whether the medications are successful, but rather the side effects you are willing to accept. I can give someone enough mood stabilizers that they’re bedbound for 16 hours. They’re not manic anymore, but they’re also not functional. People have to go along with their lives. So there’s this constant struggle of titrating their medications so they can function without having too many intrusive mood symptoms.
The other thing that people don’t talk about is that mania feels good. Hypomania feels good. People don’t necessarily want to get out of it once they’re in. It’s hard sometimes to convince them to take medication. By contrast, people who are depressed or miserable don’t want to be depressed, so they’ll take anything you give them.
It’s this complicated dance. You have to work with bipolar patients to take something that will control their symptoms but not be too intrusive on their life. There has to be a real team effort with everyone around to get treatment for the patient. ⧫
Contact us online or call (212) 731-2033 to learn more about our bipolar disorder services and take the first step toward conquering a challenging condition.
Mental health isn’t just a private struggle anymore; it’s a conversation happening everywhere. Whether it’s a quick scroll through social media, catching up with friends over coffee, overhearing a chat on the subway, or even standing in line waiting for the bus, people are opening up in ways they never have before.
Awareness and acceptance of mental health needs are growing, and more people, including high-profile celebrities like Lady Gaga and Zendaya, are openly sharing their experiences.
It’s an issue where women, in particular, face unique challenges related to biological changes, societal pressures, and everyday life stressors. Women are being diagnosed with mental health conditions at an increasing rate. In the U.S., 7.1% of women are diagnosed with serious mental illness compared to 4.8% of men. In New York City, an estimated 13% of women experienced depression in 2022.
Why Women Experience Higher Rates of Depression and Anxiety
Women are nearly twice as likely as men to experience depression, often due to higher rates of trauma, chronic stress from juggling multiple roles, and hormonal fluctuations. They also report higher levels of anxiety, post-traumatic stress disorder (PTSD), and eating disorders.
Additionally, social biases can lead to their concerns, struggles, and experiences being dismissed, and the stigma surrounding mental health may prevent them from seeking help. In places like New York City, where three-fourths of intimate partner violence felony assaults were against women in 2020 and 2021, the impact of trauma on mental health is especially concerning.
According to Dr. David Woo, head clinical psychiatrist and founder of Madison Avenue TMS & Psychiatry, the entrenched perception of women’s psychiatric struggles has been an ongoing barrier to women feeling comfortable seeking help.
“For a long time, symptoms of depression or anxiety have been more likely to be attributed to hysteria or over-emotionality in women than when seen in men,” he says. “This stigma causes many women to minimize their symptoms or delay seeking help.”
New and Emerging Treatments for Women’s Mental Health
The good news is that advances in mental health research are making a difference. Help is available, healthcare providers have more treatment options at their disposal, and women have more choices than ever to address their mental well-being.
Traditional Approaches: Therapy and Medication
Talking with a therapist can be helpful to many people. Medications prescribed by psychiatrists can also make a difference. However, they can come with annoying or significant side effects like weight gain, sexual dysfunction, and drowsiness. They also don’t work for everyone, may only partly work, or otherwise be “treatment resistant.” Estimates vary, but 20-30% of people with major depressive disorder don’t respond to treatment, especially amongwomen and adults aged 45-65.
Transcranial Magnetic Stimulation (TMS): A Non-Invasive Alternative to Depression Treatment
For women who have not responded to traditional treatments, suffer from medication side effects, or are looking for less invasive therapies, transcranial magnetic stimulation (TMS) is a promising alternative. TMS is an FDA-approved, non-invasive procedure overseen by a medical practitioner. It uses painless magnetic fields to stimulate nerve cells in the brain. Studies show that TMS is particularly effective for treatment-resistant depression, but also works in treating other mental health conditions like anxiety, obsessive-compulsive disorder, and postpartum depression.
There are few studies evaluating the short-term and long-term efficacy and safety of TMS for major depressive disorder (MDD) during pregnancy. The studies that have been conducted indicate that TMS is a safe and effective treatment. Women have shown improvement in both maternal functioning and depressive symptoms after receiving TMS treatment.
Unlike medication, TMS has no side effects, making it an appealing treatment. Sessions are conducted over several weeks in a clinical setting. As a bonus, patients can resume their daily activities immediately after leaving the office.
“TMS and medications have very similar success rates for women with depression. For patients who do not respond to medications and/or psychotherapy, TMS is a safe, clinically proven option,” says Dr. Woo.
Ketamine Therapy: New Emerging Treatment
Ketamine therapies like Spravato are growing in popularity for treating depression, anxiety, and PTSD, especially for those who haven’t found relief with traditional medications. Only administered in a controlled medical setting, ketamine works by rapidly restoring neural connections in the brain, increasing feelings of well-being, and easing distressing symptoms. Unlike conventional antidepressants, which can take weeks to take effect, ketamine therapy often provides relief within hours or days.
Holistic: Lifestyle and Mind-Body Interventions for Women’s Mental Health
Lifestyle interventions play a key role in mental health management. Women are incorporating regular exercise, mindfulness practices, gut health, and improved nutrition to increase well-being.
Seeking Help and Taking the First Step
If you or a loved one is struggling with mental health challenges, Madison Avenue TMS offers innovative treatments that may help. Fill out our contact form or call us at (212) 731-2033 to schedule a consultation and learn more about your options.
Seeking help is a sign of strength, and with the right support, recovery is possible.
Additional Resources:
NYC 988 Phone or text 988. Phone (Español): 988, Aprete 2. Free, confidential crisis counseling, mental health and substance misuse support, information and referral.
Burnout is a state of physical, emotional, and mental exhaustion caused by prolonged stress, often related to work. Recognized as a significant mental health concern, burnout affects millions of people globally, especially in high-pressure environments like New York, where it is a common concern among patients who seek help at Madison Avenue TMS & Psychiatry. But what is burnout, and how can it be treated? Let’s dive into it and explore burnout symptoms, risk factors, related mental health conditions, and how treatment options like medications and transcranial magnetic stimulation (TMS) can help.
Burnout, or occupational burnout, is a psychological syndrome resulting from chronic workplace stress. While it is not classified as a medical condition, the World Health Organization (WHO) identifies burnout as an occupational phenomenon with symptoms that can severely impact quality of life (1). Burnout can occur in any occupation—students or artists can be just as affected as corporate executives, laborers, or other professions.
Burnout Symptoms
Common burnout symptoms include:
Physical exhaustion: Feeling tired and drained most of the time.
Emotional exhaustion: Feeling overwhelmed, cynical, or detached from work or personal life.
Reduced performance: Struggling to focus, meet deadlines or complete tasks.
Mental health issues: Increased feelings of anxiety, depression, or hopelessness.
Physical symptoms: Headaches, stomach issues, or sleep disturbances.
The Link Between Burnout And Mental Health Conditions
Studies have shown that burnout symptoms often overlap with symptoms of depression, resulting in a condition called depression burnout, (a combination of burnout and depression) which requires professional evaluation for an accurate diagnosis (2). Antidepressants or drug-free depression treatments may then be prescribed to assist in recovery from depression burnout.
Burnout can also coexist with other mental health conditions, including:
Anxiety: Chronic stress can exacerbate these conditions.
These conditions can be triggered by burnout, or the stress of living with them while navigating the pressure of professional life can contribute to the burnout itself. Addressing these conditions is critical for effective recovery.
Risk Factors For Burnout
Certain factors make individuals more prone to burnout, including:
Work-related stress: High workloads, lack of control, or toxic workplace environments.
Personal traits: Perfectionism, overcommitment, or difficulty delegating tasks.
Life pressures: Balancing work with caregiving, financial strain, or health concerns.
Preventing burnout involves addressing stressors early and developing healthy habits. As an occupational phenomenon, factors contributing to burnout may be largely out of our control—for example, a toxic or overly exploitative work environment. Nonetheless, if you feel like you may be approaching burnout, the following tips can help to alleviate the stress:
Setting boundaries: Learn to say no and establish a work-life balance.
Time management: Break tasks into manageable steps to avoid feeling overwhelmed.
Seeking support: Lean on friends, family, or support groups.
Mindfulness and relaxation techniques: Practices like meditation or yoga can help reduce stress.
How To Recover From Burnout
Recovery is possible with the right steps. But how long does it take to recover from burnout? Depending on the individual and severity, recovery from burnout can take weeks, months, or even years, often requiring a combination of rest, therapy, and support. Steps to recovery include:
Acknowledging the problem: Recognize the signs and take them seriously.
Taking a break: Allow time to rest and recharge.
Exploring new strategies: Adopt healthier work habits and coping mechanisms.
Treatment For Burnout At Madison Avenue TMS & Psychiatry
Located in the heart of New York, Madison Avenue TMS & Psychiatry provides expert care for burnout and related mental health challenges. We offer comprehensive services designed to help you regain control and improve your quality of life, including:
Medications such as SSRIs or SNRIs can be prescribed to treat underlying issues like anxiety or depression, but they don’t necessarily work for everyone. Our medication management services include regular psychiatric consultations, conveniently available by telehealth, to monitor the effectiveness of your medications, watch for potential side effects, and adjust the drug or dosage for the best experience.
A non-invasive, FDA-approved treatment for depression, OCD, and other mood disorders, TMS is a drug-free therapy with a high success rate in treating the mental health conditions that can develop alongside burnout.
Burnout can be difficult to deal with, but you don’t have to struggle through it alone. If you or a loved one is experiencing burnout in New York, Madison Avenue TMS & Psychiatry is here to help.
Contact us online today or call (212) 731-2033 to learn more about our personalized treatment options and take the first step toward a healthier, more balanced life.
World Health Organization. Burn-out an “occupational phenomenon”: International classification of diseases. 2019. Link. Accessed January 27, 2025.
Baptista, M. N., Hauck-Filho, N., & Cardoso, H. F. (2022). The overlap between burnout and depression through a different lens: A multi-method study. Journal of Affective Disorders Reports. 2022;10,100437. Link. Accessed January 27, 2025.
Anorexia nervosa, commonly referred to as anorexia, is a serious and potentially life-threatening eating disorder characterized by an intense fear of gaining weight and a distorted body image. Individuals with anorexia nervosa often engage in extreme dieting, excessive exercise, or other behaviors to control their weight, leading to severe health consequences. In many cases, anorexia is accompanied by mood disorders such as depression, anxiety, or obsessive-compulsive disorder (OCD). This article explores anorexia nervosa symptoms, diagnosis, and how treatment options available at Madison Avenue TMS & Psychiatry, such as medication management and transcranial magnetic stimulation (TMS), can help.
Anorexia nervosa is more than just a desire to be thin; it is a complex mental health condition that requires specialized care. According to the DSM-5, anorexia nervosa diagnostic criteria include:
Restriction of energy intake relative to requirements, leading to significantly low body weight.
Intense fear of gaining weight or persistent behavior that interferes with weight gain.
Distorted self-image or lack of recognition of the seriousness of low body weight.
Although discussions of anorexia can bring to mind disturbing images of dramatically emaciated bodies, someone doesn’t have to “look anorexic” to be struggling with the disease. While anorexia is often perceived as a condition that mainly affects teenage girls, it can impact people of all ages and genders and carries a heightened risk of mortality (1).
There is also atypical anorexia nervosa, where individuals meet the psychological criteria for anorexia but maintain a weight that is considered normal or above normal. This form of anorexia can be equally dangerous and requires professional attention.
Anorexia Nervosa Symptoms
Recognizing the signs of anorexia nervosa is crucial for timely intervention. Common anorexia symptoms and signs include:
Significant weight loss or failure to maintain expected growth in adolescents.
Preoccupation with food, dieting, or body image.
Avoidance of meals or eating in public.
Ritualistic eating behaviors, such as cutting food into small pieces or eating very slowly.
Excessive exercise despite exhaustion or injury.
Physical side effects of anorexia, such as:
Fatigue and weakness.
Dizziness or fainting.
Brittle hair and nails.
Dry or yellowish skin.
Amenorrhea (loss of menstrual cycle in women).
Gastrointestinal issues such as constipation.
Anorexia Nervosa Diagnosis
Diagnosing anorexia involves a comprehensive evaluation based on the DSM-5 criteria. This typically includes:
Physical exams: Assessing the side effects of anorexia, such as malnutrition and organ function.
Psychological assessments: Identifying thoughts and behaviors associated with eating and body image.
Laboratory tests: Checking for anemia, electrolyte imbalances, and other medical issues linked to anorexia symptoms.
Anorexia And Co-Occurring Mental Health Conditions
Anorexia often occurs alongside other mental health conditions, which can complicate diagnosis and treatment. These include:
Depression: Feelings of worthlessness, hopelessness, and lack of interest in life are common.
Recovery from anorexia nervosa is possible with the right approach. Treatment often involves a combination of therapies and medical care to address the eating disorder and any co-occurring mood disorders, e.g., depression or OCD.
Talk therapy, such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT) is often employed as a first-line treatment to manage emotional regulation in individuals with anorexia.
Nutritional counseling with the guidance of dietitians can also help to restore healthy eating patterns.
Because anorexia typically co-occurs with mood disorders such as depression, anxiety, and OCD, a medical intervention is often required. These include:
Medication Management
Antidepressants or anti-anxiety medications may be prescribed to balance the brain chemistry, which can assist in emotional regulation and address co-morbid conditions. However, it’s important to note that they do not work for everyone. While some individuals tolerate certain antidepressants well, others may find them ineffective or experience side effects that are difficult to manage. Regular consultations with a mental health professional are essential to monitor the medication’s effectiveness. They can adjust the dosage, switch to a different medication, or explore alternative treatments.
TMS is a non-invasive treatment that can alleviate symptoms of depression, OCD, and anxiety associated with anorexia. It uses a helmet-like device to deliver slight magnetic pulses to targeted brain areas. By stimulating these regions, TMS helps restore healthy brain activity and balance. Research has shown TMS to be an effective treatment to combat the emotional dysregulation aspects of anorexia and can be combined with other therapies to support long-term recovery (2,3).
At Madison Avenue TMS & Psychiatry, we provide TMS as part of our holistic mental health care approach. TMS is well-tolerated and safe, making it an excellent option for individuals seeking alternatives to traditional treatments or who haven’t found relief with other methods.
Anorexia Treatment In New York
If you or a loved one is struggling with anorexia nervosa or related conditions in the New York area, Madison Avenue TMS & Psychiatry is here to help. As New Yorkers, we understand the pressures and stressors of living in the city and how it can affect our relationship with our bodies and food.
Our medication management and TMS services can support your journey to mental wellness by alleviating the co-occurring mood disorders that make anorexia recovery so challenging.
Contact us online today or call (212) 731-2033 to schedule an appointment or consultation and learn more about our anorexia nervosa treatments. Together, we can help you regain your health and well-being.
van Eeden AE, van Hoeken D, Hoek HW. Incidence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Curr Opin Psychiatry. 2021;Nov 1;34(6):515-524. Link. Accessed January 26, 2025.
Marcolini F, Ravaglia A, Tempia Valenta S, Bosco G, Marconi G, De Ronchi D, Atti AR. Severe enduring anorexia nervosa (SE-AN) treatment options and their effectiveness: a review of literature. J Eat Disord. 2024;Apr 23;12(1):48. Link. Accessed January 26, 2025.
Wu, K., Lo, Y. T., Cavaleri, J., Bergosh, M., Ipe, J., Briggs, R. G., Jann, K. B., Murray, S. B., Mason, X. L., Liu, C. Y., & Lee, D. J. Neuromodulation of Eating Disorders: A Review of Underlying Neural Network Activity and Neuromodulatory Treatments. Brain Sciences. 20204;14(3), 200. Link. Accessed January 26, 2025.
Transcranial magnetic stimulation (TMS) is an innovative treatment for depression, obsessive-compulsive disorder (OCD), and related conditions. TMS therapy has been used as a mental health treatment for over 15 years, with a high success rate. It is an FDA-approved therapy for depression and OCD and reported side effects are rare. However, TMS doesn’t necessarily work for everyone. As with any psychiatric treatment, it’s normal to have concerns about potential risks or negative experiences. Let’s explore why some people may report that TMS made them worse or say, “TMS ruined my life.”
TMS therapy involves applying tiny magnetic pulses through the scalp using a helmet-like device called a coil. It can be targeted to specific areas of the brain, such as the prefrontal cortex or amygdala (the areas of our brain associated with emotions), to stimulate the appropriate neurotransmitters that alleviate the symptoms of mood disorders like depression.
So, why would someone say, “TMS ruined my life?” Although the treatment is not considered controversial in the medical community, there are many popular misconceptions about the use of electromagnetism to treat mental health. TMS therapy is sometimes unfairly conflated with more extreme, invasive interventions, such as electroconvulsive “shock” therapy (ECT), which can have been negatively represented in pop culture. However, unlike ECT, TMS does not break the skin or require implants and is generally safe and well-tolerated.
Although the effectiveness of TMS for treating depression and OCD is well-documented, its use to treat other disorders is considered “off-label” and is the subject of ongoing research.
Negative experiences with TMS are rare, and it’s important to remember that the fact that someone else had a negative experience doesn’t mean that your experience with TMS will be negative.
While TMS is generally well-tolerated, some potential drawbacks include:
Time commitment: Requires daily clinical sessions over several weeks.
Side effects: Possible mild headaches, scalp discomfort, or muscle twitches.
Effectiveness: TMS may not work for everyone, with some patients requiring additional treatments.
Accessibility: Limited availability in some areas, with high costs for out-of-pocket payments.
Although TMS can sometimes cause some uncomfortable side effects, these are typically mild and short-lived when compared to pharmaceutical medications, as shown below:
Comparative Table: Side Effects Of TMS Vs. Antidepressants
Aspect
TMS Therapy
Antidepressants
Common Side Effects
Mild headaches
Scalp discomfort
Muscle twitching
Nausea
Weight gain
Sexual dysfunction
Systemic Effects
None, as TMS is localized to brain stimulation
Wide-ranging effects due to systemic medication
Cognitive Effects
No reported memory or cognitive impairment
Possible brain fog or concentration difficulties
Duration of Side Effects
Short-term, typically resolving after a few sessions
Long-term side effects can persist with continued use
Severity
Generally mild and well-tolerated
Can range from mild to severe, including suicidal ideation in rare cases
Dependency Potential
None
None, but withdrawal symptoms can occur if stopped abruptly
Not recommended for all antidepressants; varies by medication
Long-Term Risks
Minimal known risks
Long-term use may lead to issues like liver damage or reduced efficacy over time
Understanding TMS Therapy Negative Reviews
Whether you are considering TMS for depression, anxiety, or another mood disorder, it is only natural to look at online reviews of TMS therapy and read other people’s experiences. There are some TMS therapy negative reviews, and we should try to understand what caused them. Below, we outline some common reasons why someone might report a less-than-satisfactory experience with TMS. In all cases, remember that individual experiences do not necessarily reflect the majority or directly apply to everybody. It is crucial for individuals with mental health concerns to consult with mental health professionals to explore suitable treatment options tailored to their specific needs.
Some People May Require A Second Round Of TMS Or TMS + Another Treatment
Everyone responds to different depression treatments differently. Depression treatment often involves a long-term plan that involves trying various treatments and finding what works best for that person. People with difficult-to-treat depression may not respond to antidepressants, and it can be a challenge to find the right treatment. Some patients may require a second round of TMS, maintenance sessions, or TMS combined with another treatment option, like an antidepressant.
While it’s not common, it’s possible for someone who has bipolar disorder to be diagnosed with depression. TMS is not an approved treatment option for bipolar disorder and may make bipolar symptoms worse (1). If you’ve ever experienced symptoms of mania or hypomania, or if you have a family member who has experienced these symptoms or who has been diagnosed with bipolar disorder, it would be advisable that you get a second opinion.
“TMS Cost Me My Marriage”: Relationships And Therapy
Sometimes, individuals undergoing TMS therapy have reported challenges in their personal relationships. It’s essential to recognize that the impact of mental health treatments—not just TMS—on relationships can vary greatly from person to person. Changes in mood, energy levels, and overall well-being during and after treatment may affect the dynamics of a relationship. Open communication, education, and partner involvement in the treatment process can contribute to a more supportive environment.
Why Is TMS Making Me Worse?
Most patients go through TMS treatment with little to no side effects. However, there are some patients who experience a TMS “dip” about halfway through treatment. During a dip, a patient may experience a temporary worsening of depression or anxiety symptoms. In our clinic, roughly 20% of our patients experience a temporary dip around week two or three of treatment.
What Does A TMS Dip Feel Like?
While not everyone experiences a TMS dip, those who do often describe it as feeling like a relapse or intensification of their depression or OCD symptoms.
Increased sadness or low mood: You might feel more emotionally unstable as the treatment “wakes up” certain brain regions that were previously underactive.
Heightened anxiety: Some patients report feeling more restless or on edge than usual.
Fatigue or lack of energy: Symptoms like tiredness or difficulty focusing may temporarily worsen.
Irritability or frustration: Patients may feel impatient or agitated, especially if they expected rapid improvement.
Doubts about treatment effectiveness: The dip can lead to feelings of discouragement or hopelessness regarding the therapy.
TMS isn’t the only depression treatment that can cause a dip. For example, patients taking antidepressants may also feel a dip at the beginning of treatment. At first, patients may notice a worsening of their symptoms and may experience unpleasant side effects before feeling better. Antidepressants take time to work and for patients to get the full benefits. For this reason, doctors encourage patients to stick with an antidepressant for 6 to 8 weeks before deciding if it’s not working.
If you’re experiencing a dip in your symptoms while being treated for depression, talk to your doctor. It’s important to continue treatment, even if you experience a dip. Your doctor can help you manage symptoms during a dip.
Can TMS Make Depression Worse?
While TMS has demonstrated positive outcomes for many individuals with depression, there are cases where the treatment may not be as effective. Factors such as the severity of depression, individual response to the treatment, and underlying physiological conditions can influence its success. In response, new TMS techniques such as theta burst stimulation or deep TMS, also available at Madison Avenue TMS & Therapy, have been developed to treat individuals for whom standard TMS was ineffective (2). However, there is no evidence to suggest that TMS can make depression worse in individuals whose conditions were correctly diagnosed.
Can TMS Make Anxiety Worse?
TMS is primarily recognized for its application in treating depression. However, research on TMS for anxiety is ongoing (3). Although results so far are promising, individual responses may vary.
The Bottom Line: TMS Is Proven To Be Safe And Effective In Treating Depression
Studies show by and large that TMS is extremely safe and highly effective when used correctly and when the patient is diagnosed correctly with a disorder that TMS is known to treat, like depression (4).
Additionally, patients meet regularly with their psychiatrist during and after TMS treatment. During this time, your doctor will ask how you are handling treatment and will make adjustments if needed.
While some people may have a negative experience with TMS and may say that “TMS ruined my life,” we don’t recommend that patients make their decisions based on what happened to a few people. Based on the results from numerous real-world clinical studies, chances are that TMS will work for you.
Ready to take the next step towards a brighter, healthier mind? Our team at Madison Avenue TMS & Psychiatry is dedicated to providing compassionate, innovative care to individuals in the New York area. With TMS therapy, many have found a path to improved well-being and relief from depression symptoms.
Hyde, J., Carr, H., Kelley, N., Seneviratne, R., Reed, C., Parlatini, V., et al. Efficacy of neurostimulation across mental disorders: systematic review and meta-analysis of 208 randomized controlled trials. Mol Psychiatry. 2022;27:2709–19. Link. Accessed January 03, 2024.
Cheng, CM., Li, CT., Tsai, SJ. Current Updates on Newer Forms of Transcranial Magnetic Stimulation in Major Depression. In: Kim, YK. (eds) Major Depressive Disorder. Advances in Experimental Medicine and Biology, vol 1305. Springer, Singapore. 2021. Link. Accessed Jan 03, 2024.
Trevizol, A. P., Downar, J., Vila-Rodriguez, F., Konstantinou, G., Daskalakis, Z. J., & Blumberger, D. M. Effect of repetitive transcranial magnetic stimulation on anxiety symptoms in patients with major depression: An analysis from the THREE-D trial. Depression and Anxiety. 2021;38(3), 262-271. Link. Accessed Jan 03, 2024.
Tendler, A., Goerigk, S., Zibman, S., Ouaknine, S., Harmelech, T., Pell, G., Zangen, A., Harvey, S., Grammer, G., Stehberg, J., Adefolarin, O., Muir, O., MacMillan, C., Ghelber, D., Duffy, W., Mania, I., Faruqui, Z., Munasif, Fi., Antin, T., Padberg, F., Roth, Y. Deep TMS H1 Coil treatment for depression: Results from a large post marketing data analysis. Psychiatry Research. 2023;324. Link. Accessed January 03, 2024.
The start of a new year often inspires change and self-improvement, especially for our health. After all, what is a New Year’s resolution if not a promise you make to yourself to get better? Whether we resolve to achieve a specific goal, improve a habit, or embark on a new journey, making this kind of ritualized promise puts us in the right mindset to succeed. For individuals with mental health conditions, a New Year’s resolution can be an empowering tool to set intentions, build structure, and foster a sense of accomplishment.
In this article, we’ll explore how resolutions relate to mental health, suggest some good New Year’s resolution ideas, and explain how Madison Avenue TMS & Psychiatry can support your mental health goals.
What Are Some New Year’s Resolutions For Mental Health?
The holidays can be tough for many of us. Whether we are managing stressors at family gatherings, struggling to live up to expectations, or experiencing seasonal depression, it’s important to resist the temptation to wallow and try to use our holiday reflection time to take positive steps towards better mental health.
Resolutions focused on mental health don’t have to be grand or overwhelming. Instead, they should align with your needs and be achievable. Here are some good New Year’s resolutions tailored for mental health:
Prioritize self-care: Dedicate time daily for relaxation or hobbies.
Start a gratitude journal: Write three things you’re grateful for daily.
Practice mindfulness: Try meditation or breathing exercises to manage stress.
Improve sleep hygiene: Set a consistent bedtime and reduce screen time before bed.
Strengthen social connections: Reach out to friends and family regularly.
Break the stigma: Talk openly about mental health with friends and family.
Focus on nutrition: Make small changes to eat healthier meals that boost mood.
New Year’s resolutions offer opportunities for personal growth, but sticking to them can be challenging. Insights from recent research provide practical advice on how to maintain well-being and increase your chances of success:
1. Focus on approach-oriented goals
A study published in PLOS ONE found that approach-oriented resolutions, which focus on adopting positive behaviors (e.g., “I will eat more vegetables” rather than “I will stop eating junk food”), are more successful. Participants with approach-oriented goals had a success rate of nearly 59%, compared to 47% for avoidance-oriented goals (1). This suggests that framing resolutions positively can increase your motivation and likelihood of sticking to them.
Tip: When setting your resolutions, think about what you wantto achieve, not just what you want to avoid.
2. Get support
The same PLOS ONE study highlighted the importance of external support. Participants who received guidance or encouragement were significantly more likely to achieve their resolutions. Sharing your goals with friends, family, or professionals can keep you accountable and motivated.
Tip: Consider joining a community, finding an accountability partner, or seeking professional support if your resolutions involve mental health or lifestyle changes.
3. Be flexible with your goals
According to research from the International Journal of Environmental Research and Public Health, goal flexibility—your ability to adapt and adjust your goals—is linked to better mental well-being (2). While tenacity (sticking to your goals) is important, flexibility helps you maintain balance and avoid burnout when unexpected challenges arise.
Tip: Revisit your resolutions periodically and adjust them if needed. Allowing for changes doesn’t mean failure—it’s a strategy for long-term success.
4. Keep resolutions specific and attainable
Both studies emphasized the importance of specificity. Abstract or overly ambitious goals (e.g., “I’ll be healthier this year”) are harder to achieve and measure. Instead, set clear, actionable steps to guide your progress.
Tip: Use the SMART framework—make your goals Specific, Measurable, Achievable, Relevant, and Time-bound.
5. Prioritize mental well-being
The research also underlines the importance of mental health in sustaining resolutions. Flexible goal-setting and focusing on positive behaviors contribute to better well-being, improving your ability to achieve goals.
Tip: Consider incorporating mental health-focused resolutions, such as practicing mindfulness or scheduling time for self-care. If mental health challenges are a barrier, explore support options like therapy or treatments such as TMS at Madison Avenue TMS & Psychiatry. If you are currently undergoing treatment and feel like medications are not working for you, then it may be the right time to check in with a psychiatrist and explore your options.
Setting positive, flexible goals, seeking support, and prioritizing mental health can make this year’s resolutions more achievable and sustainable. Our team at Madison Avenue TMS & Psychiatry is here to help you navigate challenges and achieve your mental health and well-being goals.
Good New Year’s Resolutions For New Yorkers In 2025
Explore green spaces: Commit to spending more time in Central Park, the High Line, or other city parks to enjoy nature’s calming effects.
Commute smarter: Use your commute for mindfulness or self-improvement, such as listening to audiobooks or practicing gratitude.
Support your local community: Volunteer with local organizations to strengthen your sense of purpose and connection.
Why Resolutions Matter For Mental Health
Most mental health conditions are long-term challenges, even with effective treatment. Faced with this kind of difficulty, it can be easy to lose motivation, especially if it feels like your mind is working against you. In these cases, it can be helpful to mentally prime ourselves to meet the challenges ahead and focus on our goals.
Setting and working toward resolutions gives you a sense of control and direction. For individuals with mental health conditions, these goals can foster hope and motivation. Set yourself for success this year and support your recovery by priming yourself with some good New Year’s resolutions.
How Madison Avenue TMS & Psychiatry Can Help
If your mental health challenges are holding you back from achieving your resolutions, Madison Avenue TMS & Psychiatry is here to support you.
At Madison Avenue TMS & Psychiatry, we understand that every journey to better mental health is unique. Let your New Year’s resolutions be a stepping stone toward healing and growth this year.
Start today by scheduling a consultation or exploring our mental health services by contacting us online or calling (212) 731-2033. Your resolution to improve your mental health can transform your life in 2025 and beyond.
Pfeffer, K., & Strobach, T. (2021). Self-Regulatory Goal Motivational Processes in Sustained New Year Resolution Pursuit and Mental Wellbeing. International Journal of Environmental Research and Public Health, 18(6), 3084. Link. Accessed December 10, 2024.
Oscarsson, M., Carlbring, P., Andersson, G., & Rozental, A. A large-scale experiment on New Year’s resolutions: Approach-oriented goals are more successful than avoidance-oriented goals. PLOS ONE. 2020;15(12), e0234097. Link. Accessed December 10, 2024.
Post-traumatic stress disorder (PTSD) is a mental health condition that sometimes develops after a person has witnessed or experienced a highly stressful or traumatizing event. People affected by PTSD experience life-interfering symptoms such as flashbacks or reoccurring nightmares of the event and increased levels of anxiety and hypervigilant states.
While many PTSD symptoms resolve either on their own or with early interventions, untreated or long-term PTSD can be highly debilitating and can significantly reduce overall quality of life. The good news is that PTSD is treatable with the proper care and support of a professional and qualified mental health team. At Madison Avenue TMS & Psychiatry, we offer compassionate and expert PTSD treatment like talk therapy, medication management services, and transcranial magnetic stimulation (TMS).
While many people associate PTSD with veterans and other individuals who have experienced active combat duty or wars, anyone who has experienced a dangerous or overwhelming event can have PTSD. Some common causes of PTSD include:
Trauma exposure: Police officers, firefighters, and other first responders are especially vulnerable to developing PTSD symptoms as they routinely respond to violent crimes, accidents, sexual assaults, domestic abuse, and natural disasters. New York first responders and residents may still be suffering PTSD from the 9/11 terrorist attacks.
Combat exposure: Military personnel who experience active combat duty or civilians caught in a war zone.
Childhood trauma: Children who experience neglect, abandonment, abuse, or extreme poverty can develop PTSD symptoms.
Sudden loss: Experiencing a sudden death or loss of a significant relationship can provoke PTSD.
PTSD Symptoms
Some signs of PTSD include the following symptoms:
Intrusive memories: Reexperiencing the traumatic event either through flashbacks, reoccurring nightmares, or intrusive and distressing thoughts.
Avoidance: Avoiding people, places, or other triggers and reminders of the event that could bring back painful memories.
Negative changes in thinking and mood: Ongoing negative feelings such as guilt, shame, and emotional numbness.
Changes in physical and emotional reactions: Feelings of hypervigilance even when in a safe environment, irritability, and sleep issues.
While not everyone who experiences a dangerous or shocking event will develop PTSD, if someone is showing signs of PTSD, it is crucial to seek out care.
PTSD Statistics and Impact
Every year, 3.5% of the population is estimated to experience PTSD.
The overall lifetime risk of PTSD is 6.8%.
Specific demographics face higher risks:
Women are twice as likely as men to develop PTSD symptoms.
Military personnel have a lifetime risk of 9.4%.
PTSD is often diagnosed alongside other disorders, a phenomenon known as comorbidity, such as anxiety, depression, or substance abuse. Suicidal ideation and tendencies are also common (1).
PTSD Treatment Options
The first line of treatment for PTSD is either medication, psychotherapy, or a combination of both. If patients do not see significant improvements in their conditions, they might consider TMS, which has been shown to be effective in treating PTSD symptoms.
Medication Management
Medication can help manage the chemical imbalances in the brain that contribute to PTSD. The most common medications prescribed are:
Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) like sertraline and paroxetine are commonly prescribed to reduce symptoms such as anxiety and depression.
Anti-anxiety medications: PTSD patients are often stuck in a “flight or fight” response and experience bouts of intense anxiety. The use of these medications helps reduce hypervigilance states and lower anxious feelings.
Psychotherapies are often central to PTSD treatment, offering patients strategies to process trauma and build resilience. Two of the most effective therapies for PTSD are:
Cognitive behavioral therapy (CBT): Focuses on identifying and changing negative thought patterns and behaviors associated with trauma.
Transcranial magnetic stimulation (TMS) is an FDA-cleared non-invasive brain stimulation therapy that directly targets the areas of the brain affected by PTSD. Over several weeks of 20-60 minute sessions, patients wear a type of helmet on their scalp through which electromagnetic pulses are sent into the brain, helping to create new neural pathways.
Recent preliminary studies state that TMS consistently reduces PTSD symptoms as well as comorbidity conditions like depression and/or anxiety (2). While more research is needed to determine the lasting effects of TMS and optimize its application for PTSD, TMS is safe and effective for treating PTSD (3).
If you want to learn more about how TMS can help you or a loved one manage PTSD symptoms, reach out today and learn more on our website.
Telehealth Consultations
Remote access to therapy for ongoing support makes it convenient for New Yorkers with busy schedules or long commutes to receive the proper care and attention they need and deserve. Talk to a caring professional from the comfort of your own home or office at a convenient time.
Schedule your appointment today with Madison Avenue TMS & Psychiatry.
If you or a loved one are experiencing PTSD symptoms and are located in the New York area, do not hesitate to schedule a consultation today via our website or by calling (212) 731-2033.
PTSD can be a debilitating and isolating condition, but it doesn’t have to be. With the right support and interventions from our team of caring professionals, recovery is more than possible.
Sareen J. Posttraumatic stress disorder in adults: impact, comorbidity, risk factors, and treatment. Can J Psychiatry. 2014;59(9):460-467. Link. Accessed November 15, 2024.
Saccenti D, Lodi L, Moro AS, et al. Novel Approaches for the Treatment of Post-Traumatic Stress Disorder: A Systematic Review of Non-Invasive Brain Stimulation Interventions and Insights from Clinical Trials. Brain Sci. 2024;14(3):210. Link. Accessed October 15, 2024.
Petrosino NJ, Cosmo C, Berlow YA, Zandvakili A, van ’t Wout-Frank M, Philip NS. Transcranial magnetic stimulation for post-traumatic stress disorder. Therapeutic Advances in Psychopharmacology. 2021;11. Link. Accessed November 14, 2024.
Selective serotonin and norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant medications commonly used to treat mental health disorders such as depression, anxiety, and other related conditions. These medications can sometimes be confused with the similarly named selective serotonin reuptake inhibitors (SSRIs). However, there are crucial distinctions between them when it comes to best treatment practices and side effects.
Understanding the differences between SNRIs, SSRIs, and alternative drug-free depression therapies like transcranial magnetic stimulation (TMS) can help patients and caregivers make informed decisions about treatment. At Madison Avenue TMS & Psychiatry, we help people in the New York area overcome their mental health issues, and that starts with an understanding of what each therapy can offer. This article will explore the effectiveness of SNRIs, their risks, and how they compare to other treatment options.
SNRIs and SSRIs are both types of antidepressants. As their names suggest, they both work on serotonin. Serotonin is a neurotransmitter—a type of chemical that helps transmit signals in the brain. It plays a key role in regulating mood, emotions, and other functions such as sleep, appetite, and digestion. Low levels of serotonin are often linked to depression, as they affect mood stability and feelings of well-being.
SSRIs target serotonin alone, increasing its levels in the brain by blocking its reuptake. The theory behind these antidepressants is that, by increasing serotonin levels in the brain, they improve communication between brain cells and alleviate symptoms of depression.
SNRIs affect both serotonin and norepinephrine. Norepinephrine is another neurotransmitter that plays a vital role in regulating mood, attention, and the body’s stress response. It is related to our “fight or flight” response, impacting heart rate, blood pressure, and energy levels. In terms of depression, low levels of norepinephrine are linked to feelings of lethargy, lack of focus, and a diminished ability to handle stress. SNRIs increase norepinephrine, making them more versatile for conditions involving energy levels and concentration, such as attention-deficit hyperactivity disorder (ADHD) and anxiety.
Am I Taking An SSRI Or SNRI?
If you’re unsure which medication you are taking, check the label and brand name.
SSRI list of common medications:
Fluoxetine (Prozac)
Sertraline (Zoloft)
Escitalopram (Lexapro)
Paroxetine (Paxil)
SNRI list of common medications:
Venlafaxine (Effexor)
Duloxetine (Cymbalta)
Desvenlafaxine (Pristiq)
Levomilnacipran (Fetzima)
Conditions Treated
The distinctive chemical interactions of SSRIs and SNRIs make them more suitable for treating different symptoms, even if they are both used for depression and anxiety.
SNRIs are prescribed for depression, generalized anxiety disorder (GAD), ADHD, PTSD, and chronic pain conditions like fibromyalgia.
Side Effects
Side effects are a major issue in both types of antidepressants, although the different chemical effects of each medication mean that certain side effects can be more likely with SSRIs or SNRIs.
SSRIside effects include nausea, weight gain, and sexual dysfunction.
SNRI side effects can include similar side effects as SSRIs. However, the increased norepinephrine may also cause increased heart rate and blood pressure. Other side effects associated with SNRIs include:
Constipation (a commonly reported SNRI side effect)
Side effects vary in frequency, intensity, and prevalence, but they are widely felt enough to seriously impact medication adherence, making antidepressants ineffective as a treatment for some people (1, 2, 3, 4).
Not everyone reacts to medication in the same way, which is why we recommend regular consultations with a psychiatric professional to find the best one for you.
Recent studies show that SNRIs can be highly effective for treating various conditions. In particular, they are prescribed to patients where anxiety symptoms are more significant and in cases where mental symptoms are also combined with physical pain or fatigue. The dual-action mechanism makes them suitable for patients with complex symptom profiles, such as combined anxiety and depression.
Advantages of SNRI vs. SSRI medications
Symptom relief: SNRIs may provide broader symptom relief, especially when physical symptoms like chronic pain are present alongside mood disturbances.
Energy and motivation: SNRIs can be more beneficial for patients experiencing low energy and motivation due to their effect on norepinephrine, making them a good option for ADHD and fatigue-related depression.
Summing Up: SSRI vs. SNRI Comparison Table
Feature
SSRIs (Selective Serotonin Reuptake Inhibitors)
SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors)
Mechanism of Action
Increases serotonin levels by blocking reuptake
Increases both serotonin and norepinephrine by blocking reuptake
Conditions Treated
Depression, anxiety, PTSD, OCD
Depression, anxiety, PTSD, ADHD, chronic pain
Common Medications
– Fluoxetine (Prozac)
– Venlafaxine (Effexor)
– Sertraline (Zoloft)
– Duloxetine (Cymbalta)
– Escitalopram (Lexapro)
– Desvenlafaxine (Pristiq)
Side Effects
Nausea, weight gain, sexual dysfunction
Similar to SSRIs + potential for increased heart rate, high BP
Energy and Motivation Impact
Typically neutral or sedative effect
May increase energy and focus, beneficial for ADHD
Withdrawal Symptoms
Can be significant (discontinuation syndrome)
Often more intense due to dual neurotransmitter action
Effectiveness
Effective for mood and anxiety disorders
Effective for mood disorders with additional benefits for pain and concentration
Best for
Primary mood disorders like depression and anxiety
Depression with additional symptoms like fatigue or chronic pain
What If Medication Doesn’t Work? Exploring Alternative Therapies
For people who don’t respond to medications, there are other treatment options available that can offer long-term relief from symptoms even when antidepressants or other drugs have failed.
Ketamine therapyfor depression is delivered via an FDA-approved nasal spray (esketamine). With a controlled dose delivered in a clinical setting, ketamine offers fast-acting relief for particularly acute cases of depression.
Medication Management And TMS In NYC
If you or a loved one are struggling with mental health issues, Madison Avenue TMS & Psychiatry is here to help. Our team is dedicated to providing compassionate care that empowers patients to take control of their mental health, including medication management and alternatives such as TMS and ketamine therapy. Contact us online today or call (212) 731-2033 to schedule a consultation and take the first step toward a brighter future.
Marks, S. A clinical review of antidepressants, their sexual side-effects, post-SSRI sexual dysfunction, and serotonin syndrome. British Journal of Nursing. 2023;32(14), 678. Link. Accessed October 19, 2024.
Pillinger, Toby et al. Antidepressant and antipsychotic side-effects and personalised prescribing: a systematic review and digital tool development. The Lancet Psychiatry. 2023;10(11), 860 – 876. Link. Accessed October 19, 2024.
Niarchou, E., Roberts, D. L., & Naughton, B. D. (2024). What is the impact of antidepressant side effects on medication adherence among adult patients diagnosed with depressive disorder: A systematic review. Journal of Psychopharmacology. Link. Accessed October 19, 2024.
Braund TA, Tillman G, Palmer DM, Gordon E, Rush AJ, Harris AWF. Antidepressant side effects and their impact on treatment outcome in people with major depressive disorder: an iSPOT-D report. Transl Psychiatry. 2021;;11(1):417. Link. Accessed October 19, 2024.
Han EH, Kim H, Lee KJ. Comparison of Effect of SSRIs and SNRIs on Depression, Pain and Somatic Symptoms in Elderly Patients with Major Depressive Disorder. Korean Journal of Psychosomatic Medicine.. 2020 Jun 30;28(1):72–80. Link. Accessed October 19, 2024.
Stefánsdóttir, Í. H., Ivarsson, T., & Skarphedinsson, G. Efficacy and safety of serotonin reuptake inhibitors (SSRI) and serotonin noradrenaline reuptake inhibitors (SNRI) for children and adolescents with anxiety disorders: a systematic review and meta-analysis. Nordic Journal of Psychiatry. 2023;77(2), 137–146. Link. Accessed October 19, 2024.
Ferreira G E, Abdel-Shaheed C, Underwood M, Finnerup N B, Day R O, McLachlan A et al. Efficacy, safety, and tolerability of antidepressants for pain in adults: overview of systematic reviews. BMJ 2023; 380. Link. Accessed October 19, 2024.
Anhedonia is more than just a feeling of sadness or a temporary emotional downturn. It involves a significant loss of interest in previously pleasurable activities, which can impact daily life and relationships.
Anhedonia symptoms can be categorized into:
Social Anhedonia: Reduced interest or pleasure in social interactions.
Physical Anhedonia: Reduced ability to experience physical pleasures, such as eating or physical affection.
Anhedonia is a core symptom of major depressive disorder (MDD) and is often prominent in what is known as anhedonic depression. It can also occur in other mental health conditions, such as:
Anhedonic depression is characterized by impairments in the brain’s neurotransmitter systems, especially a decrease in dopamine activity (1). Dopamine is a crucial part of the brain’s reward system, which controls motivation and pleasure. When you lack dopamine, formerly pleasurable activities can feel dull and uninteresting.
Comparing Anhedonia Treatments
Treatment for anhedonia typically involves a combination of therapies and medications, such as:
Talk therapy: Conversational techniques that focus on changing negative thought patterns, such as cognitive behavioral therapy (CBT), can help the patient manage their symptoms. However, additional treatment is usually required to address the underlying brain chemistry imbalances that cause anhedonia.
Anhedonia Medications:
Selective Serotonin Reuptake Inhibitors (SSRIs): These commonly used antidepressants that increase the availability of serotonin in the brain.
Dopamine agonists: These drugs help increase serotonin or dopamine levels.
Limitations Of Medications For Anhedonia
Many patients do not respond adequately to medications, and side effects can sometimes outweigh the benefits. For example, while SSRIs can effectively improve mood symptoms in depression, they can also indirectly inhibit dopamine release in certain brain regions, which can make anhedonia worse.
These kinds of counterproductive side effects illustrate why depression medication should always be accompanied by regular consultations with a psychiatric professional. At Madison Avenue TMS & Psychiatry, we offer medication management services to help patients find the medication type and dosage that works best for them as well as assess potential risks and side effects. These consultations are conveniently accessible via telehealth video chats, making it easy to arrange sessions at a time and place that suits your schedule.
TMSfor anhedonia is gaining attention as an anhedonia treatment due to its effectiveness in targeting specific brain regions associated with mood regulation:
Research Support: The efficacy of TMS as an anhedonia treatment is well-documented, with numerous studies showing that treatment reduces both anhedonia symptoms and suicidal ideation as well as general depression symptoms (2, 3, 4).
Anhedonia Therapy At Madison Avenue TMS & Psychiatry
Dealing with anhedonia can be challenging, but it’s important to know that there are effective treatments available. At Madison Avenue TMS & Psychiatry, we offer an integrative approach to treating anhedonia, combining:
Medication Management: Finding the right anhedonia medication suited to individual needs.
Telehealth Consultations: Convenient access to psychiatric consultations from the comfort of home.
TMS Therapy: Non-invasive and effective, particularly for those with treatment-resistant depression. We use the latest innovative TMS treatments, including deep TMS therapy, a technique that allows for a more targeted, effective therapy for specific symptoms.
If you or a loved one is struggling with anhedonia, contact us online or call (212) 731 2033 today. Our team is here to help you find joy and pleasure in life again, starting with a consultation that could pave the way to recovery and renewed well-being.
Dresp-Langley, B. From Reward to Anhedonia-Dopamine Function in the Global Mental Health Context. Biomedicines. 2023;11(9), 2469. Link. Accessed September 13, 2024.
Wang X, He K, Chen T, Shi B, Yang J, Geng W, et al. Therapeutic efficacy of connectivity-directed transcranial magnetic stimulation on anticipatory anhedonia. Depress Anxiety. 2021;38:972–984. Link. Accessed September 13, 2024.
Sonmez, A. I., Webler, R., Krueger, A. M., Godoy-Henderson, C., Sullivan, C., Wilson, S., Olsen, S., Schmid, S., Herman, A., Widge, A., Peterson, C., Nahas, Z., & Albott, C. S. Effects of TMS on anhedonia and suicidal ideation in treatment-resistant depression: Outcomes from the University of Minnesota Interventional Psychiatry Program. Journal of Mood & Anxiety Disorders. 2024;8, 100073. Link. Accessed September 13, 2024.
Wang, Y., Y. Lui, S. S., & K. Chan, R. C. The effect of noninvasive brain stimulation on anhedonia in patients with schizophrenia and depression: A systematic review and meta-analysis. PsyCh Journal. 2024;13(2), 166-175. Link. Accessed September 13, 2024.
(212) 731-2033